Co-creation of sexual and reproductive health literacy interventions and access to healthcare services among higher education students: using the Nominal Group Technique

Introduction: Limited sexual and reproductive health literacy (SRHL) among higher education students poses a significant public health challenge, hindering informed decision-making and equitable access to essential services. This study aimed to identify and prioritise effective, student-centred SRHL interventions to enhance health outcomes and reduce disparities. Methodology: A participatory approach was employed, combining student focus groups with a structured Nominal Group Technique (NGT) session involving health and education professionals. Student insights informed the initial intervention design. Prioritisation was guided by the APEASE criteria (Acceptability, Practicability, Effectiveness, Affordability, Side effects/Safety, and Equity). Results: Twenty-two proposals were consolidated into twenty interventions and ranked by an expert panel. The highest priority was assigned to the establishment of an on-campus Integrated Health Hub to centralise SRH services and improve accessibility. Other top-ranked interventions included peer-led education, interactive seminars with community stakeholders, and screening campaigns. Less integrated approaches, such as standalone informational resources, were ranked lower. The findings underscored the crucial role of health literacy mediators, particularly nurses and trained peers, and supported hybrid delivery models combining digital and in-person formats. Conclusion: Co-created, multidisciplinary SRHL strategies incorporating nursing leadership, peer engagement and institutional support are vital to addressing health inequities among higher education students. These models hold strong potential to increase SRH service uptake and promote student wellbeing. Further research should explore their long-term impact and scalability across diverse academic contexts.